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100620

registered interest
date	23/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how the Secretary of State for Health has discharged his duty to report on the treatment of National Health Service health care providers as specified in section 8 of the Health and Social Care Act 2012.
tabling member printed	Lord Hunt of Kings Heath
uin	HL2351
answer	answer is ministerial correction date of answer 31/10/2014 answer text <p>The Secretary of State commissioned Monitor to lead a Fair Playing Field Review into the equal treatment of providers of National Health Service services. The Review published its final Report in March 2013. Since publication, Monitor has established a high level implementation group, of which the Department is a member, to take forward the Review’s recommendations.</p><p> </p><p><strong> </strong></p><p> </p><p>As part of its annual assurance processes the Department seeks confirmation from all its Directors General that they and our Arm’s Length Bodies have taken the duty into consideration, as outlined in Section 8 of the Health and Social Care Act 2012.</p><p> </p> answering member printed Earl Howe question first answered 31/10/2014 13:18:46 answering member 2000 label Biography information for Earl Howe
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

100623

registered interest
date	23/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	NHS: Cost Effectiveness
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether the "Nicholson Challenge" still operates within the National Health Service; if so, what efficiency savings have been identified to date; and, if not, why not.
tabling member printed	Lord Sharkey
uin	HL2354
answer	answer is ministerial correction date of answer 30/10/2014 answer text <p>The 2010 Spending Review protected health funding in real terms. However, in order to continue to meet rising demands while improving services, it was estimated that up to £20 billion of efficiency savings would be required over the four years from 2011-12 to 2014-15.</p><p> </p><p> </p><p> </p><p>The National Health Service response to this challenge was organised through the Quality, Innovation, Productivity and Prevention (QIPP) initiative, also known colloquially as the ‘Nicholson challenge’ after Sir David Nicholson, who was Chief Executive of the NHS at the time that QIPP originated.</p><p> </p><p> </p><p> </p><p>The NHS is on track to deliver up to £20 billion efficiency savings, having reported around £15 billion of efficiencies in the first three years, all of which will be reinvested into frontline care.</p><p> </p> answering member printed Earl Howe question first answered 30/10/2014 12:11:13 answering member 2000 label Biography information for Earl Howe
tabling member	4196 label Biography information for Lord Sharkey

100549

registered interest
date	22/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Tobacco: Packaging
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government whether ministerial agreement has been reached on whether the United Kingdom is to proceed with standardised tobacco packaging; and whether it had been reached when they notified the European Commission on the draft regulations.
tabling member printed	Lord Palmer
uin	HL2286
answer	answer is ministerial correction date of answer 04/11/2014 answer text <p>The Government has not yet made a final decision on whether to introduce standardised packaging of tobacco products.</p><p> </p> answering member printed Earl Howe question first answered 04/11/2014 15:43:17 answering member 2000 label Biography information for Earl Howe
tabling member	3192 label Biography information for Lord Palmer

100550

registered interest
date	22/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	IVF
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government, further to the Written Answers by Lord Darzi of Denham on 22 July 2008 (HL4926 and HL4927) and by Earl Howe on 9 July 2012 (HL1211), of how many cycles the Human Fertilisation and Embryology Authority are aware in which fresh embryo transfers took place after 15 or more eggs were collected over each of the past ten years.
tabling member printed	Lord Alton of Liverpool
uin	HL2287
answer	answer is ministerial correction date of answer 29/10/2014 answer text <p>The number of treatment cycles in which fresh embryo transfers took place after 15 or more eggs were collected, in each of the last 10 years, is shown in the following table:</p><p> </p><p> </p><p> </p><table><tbody><tr><td><p>Years</p></td><td><p>Cycles in which fresh embryo transfers took place after 15 or more eggs were collected</p></td></tr><tr><td><p>2004</p></td><td><p>5602</p></td></tr><tr><td><p>2005</p></td><td><p>5737</p></td></tr><tr><td><p>2006</p></td><td><p>5843</p></td></tr><tr><td><p>2007</p></td><td><p>6345</p></td></tr><tr><td><p>2008</p></td><td><p>6589</p></td></tr><tr><td><p>2009</p></td><td><p>7344</p></td></tr><tr><td><p>2010</p></td><td><p>7801</p></td></tr><tr><td><p>2011</p></td><td><p>8195</p></td></tr><tr><td><p>2012</p></td><td><p>8200</p></td></tr><tr><td><p>2013(1)</p></td><td><p>8128</p></td></tr></tbody></table><p> </p><p>Source: The Human Fertilisation and Embryology Authority</p><p> </p><p> </p><p> </p><p>(1) 2013 is the most recent year for which information is available.</p><p> </p> answering member printed Earl Howe question first answered 29/10/2014 12:25:39 answering member 2000 label Biography information for Earl Howe
tabling member	738 label Biography information for Lord Alton of Liverpool

100551

registered interest
date	22/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Alcoholic Drinks: Misuse
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what steps they are taking in respect of Britain's drinking culture in order to reduce liver disease deaths.
tabling member printed	Lord Taylor of Warwick
uin	HL2288
answer	answer is ministerial correction date of answer 04/11/2014 answer text <p>The Government is taking a number of steps to tackle alcohol problems and reduce alcohol-related liver disease. These are being led by Public Health England (PHE), working with partners across government and local authorities. Through the Responsibility Deal the Government is also working with industry partners to tackle alcohol problems.</p><p> </p><p> </p><p> </p><p>On 23 October 2014, PHE published its priorities for protecting and improving the nation’s health and one of the seven issues they will be focusing on is preventing and reducing the harmful effects of alcohol. This priority includes two actions relating to liver disease:</p><p> </p><p> </p><p> </p><p>- producing a framework on liver disease outlining public health actions to tackle liver disease, including alcohol; and</p><p> </p><p> </p><p> </p><p>- launching liver disease profiles to support local authority health and wellbeing boards to understand liver disease and its risk factors in their area and, in turn, design effective local population level interventions.</p><p> </p><p> </p><p> </p><p>Other key actions from PHE on alcohol and liver disease include:</p><p> </p><p> </p><p> </p><p>- developing the evidence base for what works in preventing alcoholic liver disease and increasing awareness of the harmful effects of alcohol and the impact of interventions, to support policy development nationally and locally;</p><p> </p><p> </p><p> </p><p>- supporting and promoting effective use of licensing legislation and local powers to create a safer drinking environment that encourages people who drink to do so at a lower risk levels. Part of this is improving the effectiveness of the powers directors of public health have on alcohol licencing;</p><p> </p><p> </p><p> </p><p>- encouraging and supporting people who drink to do so within the lower risk levels;</p><p> </p><p> </p><p> </p><p>- reducing the harmful impact of alcohol on individuals who already experience harm. PHE will be supporting a widespread roll-out of interventions and brief advice; and</p><p> </p><p> </p><p> </p><p>- supporting improvements in treatment provision in line with National Institute for Health and Care Excellence guidance. Locally, PHE is supporting the development of effective alcohol specialist services in secondary care and accessible, evidence-based specialist treatment for dependent drinkers.</p><p> </p> answering member printed Earl Howe question first answered 04/11/2014 15:43:53 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick

100552

registered interest
date	22/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Dementia
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what plans they have to help care for dementia patients in the community.
tabling member printed	Lord Taylor of Warwick
uin	HL2289
answer	answer is ministerial correction date of answer 30/10/2014 answer text <p>Dementia is a key priority for this Government and we are committed to ensuring people with dementia and their carers receive the best possible care in all care settings. That is why in 2012 we launched the first ever Prime Minister’s Challenge on dementia to increase diagnosis rates, raise awareness and understanding and double funding for research in dementia by 2015.</p><p> </p><p> </p><p> </p><p>A number of steps have been taken to help care for dementia patients in the community:</p><p> </p><p> </p><p> </p><p>- On 1 April 2014 we put in place a new Dementia Directed Enhanced Service, which has had over 80% take up by general practitioners to reward practices for facilitating timely diagnosis and support for people with dementia.</p><p> </p><p> </p><p> </p><p>- In the hospital setting, through the Dementia Commissioning for Quality and Innovation reward (introduced from April 2012), with around 4,000 referrals a month, it is clear that more people with dementia in hospitals are being identified and assessed.</p><p> </p><p> </p><p> </p><p>- The Dementia Care &amp; Support Compact, the care sector’s own response to the Prime Minister’s Challenge on Dementia, sets out a commitment to support the delivery of the challenge and improve care and support for people with dementia, their carers and families.</p><p> </p><p> </p><p> </p><p>- Health Education England, Skills for Care and Skills for Health launched pilots for the new Care Certificate on 28 April 2014. Taking place across a range of health and social care settings, the pilots are testing a set of standards designed to help employers to assess not only workers’ skills, but also the knowledge, behaviours and values that are required to deliver compassionate and quality care. The pilots are nearing completion. Subject to evaluation, we plan to introduce the Care Certificate by 1 April 2015.</p><p> </p><p> </p><p> </p><p>- The Government’s refreshed Mandate to Health Education England, published on 1 May 2014, builds on the existing ambition to have 100,000 National Health Service staff receive Tier 1 training on dementia by setting an ambition for a further 250,000 NHS staff to receive Tier 1 training on dementia by March 2015, with the tools and training opportunities being made available to all staff by the end of 2018.</p><p> </p><p> </p><p> </p><p>- 70 communities across England have signed up to the national Dementia Friendly Communities recognition process, with an increased ambition to reach 75 by March 2015.</p><p> </p><p> </p><p> </p><p>- On 7 May 2014 Public Health England and the Alzheimer’s Society launched a major new campaign with the aim of securing one million people to become dementia friends by March 2015. The campaign is aimed at improving understanding and attitudes about dementia and towards people with the condition. There are currently over 520,000 Dementia Friends.</p><p> </p><p> </p><p> </p><p>- We have made available £50 million capital funding for 2013-14 for the NHS and local authorities to work with providers to create better care environments to help people with dementia live well with the condition. The projects are now in the process of being evaluated and we will disseminate the key recommendations by the end of the year.</p><p> </p> answering member printed Earl Howe question first answered 30/10/2014 16:22:09 answering member 2000 label Biography information for Earl Howe
tabling member	1796 label Biography information for Lord Taylor of Warwick

100590

registered interest
date	22/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Orthopaedics
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what action they have (1) considered, and (2) taken, to reduce the number of preventable amputations occurring within the National Health Service.
tabling member printed	Lord Harrison
uin	HL2327
answer	answer is ministerial correction date of answer 04/11/2014 answer text <p>Diabetes is one of the most common causes of amputations in the United Kingdom and there are a variety of mechanisms in place to support the care of people with diabetes to minimise the risk of amputations. NHS England published Action for Diabetes, which sets out that in many cases amputation as a result of diabetes is avoidable.</p><p> </p><p> </p><p> </p><p>NHS England has also piloted a diabetes service specification in a small number of clinical commissioning groups (CCGs). Feedback has been very positive and they have now published the service specification on the NHS Commissioning Assembly website so that it is available nationally for CCGs to use.</p><p> </p><p> </p><p> </p><p>In addition, the National Diabetes Foot Care Audit was launched this year. The audit aims to establish the extent to which national guidelines on the management of diabetic foot disease are being met, and will provide local teams with the evidence needed to tackle any identified differences in practice which will lead in turn to an overall improvement in management and outcomes for patients.</p><p> </p><p> </p><p> </p><p>Finally, NHS Improving Quality is supporting a project to reduce the high mortality associated with diabetic foot disease. People with diabetic foot disease are at particularly high risk of premature death, much of which is due to cardiovascular disease, with 5 year mortality for those with Type 1 or Type 2 diabetes and diabetic foot disease around 50%. The project will pilot an approach in several multidisciplinary foot clinics across the country over the next 18 months to introduce an additional clinical pathway which includes a cardiological test and subsequent actions to address risk.</p><p> </p> answering member printed Earl Howe question first answered 04/11/2014 12:33:24 answering member 2000 label Biography information for Earl Howe
tabling member	2488 label Biography information for Lord Harrison

100591

registered interest
date	22/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Orthopaedics
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government in how many Clinical Commissioning Groups rates of (1) major, and (2) minor, amputations are more than 33 per cent above the national average; and how the national average compares with other European Union member states.
tabling member printed	Lord Harrison
uin	HL2328
answer	answer is ministerial correction date of answer 29/10/2014 answer text <p>It is not possible to distinguish in Hospital Episode Statistics between 'major' and 'minor' amputations.</p><p> </p><p>The Health and Social Care Information Centre (HSCIC) has calculated the England average rate of amputation per 100,000 population and highlighted the clinical commissioning groups (CCGs) of residence having rates more than 33% higher than the national average. There are 25 such CCGs.</p><p> </p><p>This is not a count of people as the same person may have had more than one episode of care within the same time period.</p><p> </p><p>We do not have information on a comparison of rates of amputation with other European Union member states.</p><p> </p><table><tbody><tr><td><p>Clinical Commissioning Group of residence</p></td><td><p>Count of finished consultant episodes</p></td><td><p>Population</p></td><td><p>Rate per 100,000 population</p></td></tr><tr><td><p>NHS SCARBOROUGH AND RYEDALE CCG</p></td><td><p>68</p></td><td><p>110,488</p></td><td><p>61.5</p></td></tr><tr><td><p>NHS EAST RIDING OF YORKSHIRE CCG</p></td><td><p>169</p></td><td><p>314,504</p></td><td><p>53.7</p></td></tr><tr><td><p>NHS DONCASTER CCG</p></td><td><p>159</p></td><td><p>302,739</p></td><td><p>52.5</p></td></tr><tr><td><p>NHS MANSFIELD AND ASHFIELD CCG</p></td><td><p>101</p></td><td><p>192,539</p></td><td><p>52.5</p></td></tr><tr><td><p>NHS BLACKPOOL CCG</p></td><td><p>72</p></td><td><p>141,976</p></td><td><p>50.7</p></td></tr><tr><td><p>NHS KNOWSLEY CCG</p></td><td><p>74</p></td><td><p>145,936</p></td><td><p>50.7</p></td></tr><tr><td><p>NHS DURHAM DALES, EASINGTON AND SEDGEFIELD CCG</p></td><td><p>138</p></td><td><p>273,043</p></td><td><p>50.5</p></td></tr><tr><td><p>NHS KERNOW CCG</p></td><td><p>272</p></td><td><p>540,178</p></td><td><p>50.4</p></td></tr><tr><td><p>NHS FAREHAM AND GOSPORT CCG</p></td><td><p>98</p></td><td><p>196,078</p></td><td><p>50.0</p></td></tr><tr><td><p>NHS LANCASHIRE NORTH CCG</p></td><td><p>78</p></td><td><p>158,528</p></td><td><p>49.2</p></td></tr><tr><td><p>NHS NORTHERN, EASTERN AND WESTERN DEVON CCG</p></td><td><p>421</p></td><td><p>869,408</p></td><td><p>48.4</p></td></tr><tr><td><p>NHS STOKE ON TRENT CCG</p></td><td><p>124</p></td><td><p>258,114</p></td><td><p>48.0</p></td></tr><tr><td><p>NHS TELFORD AND WREKIN CCG</p></td><td><p>80</p></td><td><p>167,682</p></td><td><p>47.7</p></td></tr><tr><td><p>NHS HEREFORDSHIRE CCG</p></td><td><p>88</p></td><td><p>184,932</p></td><td><p>47.6</p></td></tr><tr><td><p>NHS HULL CCG</p></td><td><p>122</p></td><td><p>257,204</p></td><td><p>47.4</p></td></tr><tr><td><p>NHS NORTH KIRKLEES CCG</p></td><td><p>88</p></td><td><p>186,706</p></td><td><p>47.1</p></td></tr><tr><td><p>NHS BOLTON CCG</p></td><td><p>131</p></td><td><p>278,984</p></td><td><p>47.0</p></td></tr><tr><td><p>NHS EAST STAFFORDSHIRE CCG</p></td><td><p>58</p></td><td><p>123,945</p></td><td><p>46.8</p></td></tr><tr><td><p>NHS COASTAL WEST SUSSEX CCG</p></td><td><p>222</p></td><td><p>476,677</p></td><td><p>46.6</p></td></tr><tr><td><p>NHS LINCOLNSHIRE EAST CCG</p></td><td><p>106</p></td><td><p>228,111</p></td><td><p>46.5</p></td></tr><tr><td><p>NHS HALTON CCG</p></td><td><p>58</p></td><td><p>125,692</p></td><td><p>46.1</p></td></tr><tr><td><p>NHS NEWARK &amp; SHERWOOD CCG</p></td><td><p>53</p></td><td><p>115,897</p></td><td><p>45.7</p></td></tr><tr><td><p>NHS THANET CCG</p></td><td><p>62</p></td><td><p>135,661</p></td><td><p>45.7</p></td></tr><tr><td><p>NHS SOMERSET CCG</p></td><td><p>243</p></td><td><p>534,950</p></td><td><p>45.4</p></td></tr><tr><td><p>NHS BRADFORD CITY CCG</p></td><td><p>37</p></td><td><p>82,319</p></td><td><p>44.9</p></td></tr></tbody></table><p> </p> answering member printed Earl Howe question first answered 29/10/2014 12:26:37 answering member 2000 label Biography information for Earl Howe
tabling member	2488 label Biography information for Lord Harrison

100592

registered interest
date	22/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	GP Practice Lists: Immigration
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government (1) what is the average length of a general practitioner practice list; (2) what has been the level of net immigration since 2000; and (3) what is the number of additional general practitioners they estimate to have been required because of that immigration change since 2000.
tabling member printed	Lord Blencathra
uin	HL2329
answer	answer is ministerial correction date of answer 30/10/2014 answer text <p>Figures for 30 September 2013, the latest date for which published figures are available, showed the average number of patients per general practitioner practice was 7,034.</p><p> </p><p> </p><p> </p><p>Information on the level of net immigration for 2000 to 2012 is published by the Office of National Statistics at:</p><p> </p><p> </p><p> </p><p>http://www.ons.gov.uk/ons/rel/migration1/long-term-international-migration/2012/table-2-01a.xls</p><p> </p><p> </p><p> </p><p>Final data, for 2013, will be released on 27 November 2014.</p><p> </p><p> </p><p> </p><p>No estimates are made of the number of additional general practitioners needed specifically related to immigration changes.</p><p> </p> answering member printed Earl Howe question first answered 30/10/2014 16:23:07 answering member 2000 label Biography information for Earl Howe
tabling member	497 label Biography information for Lord Blencathra

100595

registered interest
date	22/10/2014
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Ebola
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what assessment they have made of the research report by the Keenan Research Centre at St Michael's Hospital in Toronto which estimates that three ebola carriers fly out of the most affected countries each month and that their preferred destination is London; and whether they have any plans to further increase ebola testing at airports.
tabling member printed	Lord Blencathra
uin	HL2332
answer	answer is ministerial correction date of answer 05/11/2014 answer text <p>The report makes a number of assumptions, including that exit screening procedures were not in place in the major affected countries. Since the report was published in August exit screening in the three most affected countries is now in place.</p><p> </p><p> </p><p> </p><p>Screening is now in operation in Heathrow, Gatwick, Birmingham and Manchester airports and at St Pancras (Eurostar). The purpose of screening is to identify, and give advice to, passengers coming from high risk areas who will be spending time in the United Kingdom. This is to provide them with relevant advice on the nature of the virus, what to be aware of, and what action to take should they begin to display any symptoms.</p><p> </p> answering member printed Earl Howe question first answered 05/11/2014 15:52:37 answering member 2000 label Biography information for Earl Howe
tabling member	497 label Biography information for Lord Blencathra